Acid Reflux and Asthma

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People with asthma are twice as likely as those without
asthma to develop the chronic form of acid reflux known as gastroesophageal
reflux disease (GERD) at one time or another. In fact, research has shown that
more than 75 percent of adults with asthma also have
GERD. The exact connection between GERD and asthma isn’t entirely clear.
However, researchers have a few theories as to why the two conditions may
coincide.

Why
GERD May Trigger Asthma

One possibility is that the repeated flow of
stomach acid into the esophagus damages the lining of the throat and the
airways to the lungs. This can lead to breathing difficulties as well as a
persistent cough. The frequent exposure to acid may also make the lungs more
sensitive to irritants, such as dust and pollen, which are all known to trigger
asthma.

Another possibility is that acid reflux may
trigger a protective nerve reflex. This nerve reflex causes the airways to tighten
in order to prevent the stomach acid from entering the lungs. The narrowing of
the airways can result in asthmatic symptoms, such as shortness of breath.

Why
Asthma May Trigger GERD

Just as GERD can make asthma symptoms worse,
asthma can exacerbate and trigger symptoms of acid reflux. Pressure changes
that occur inside the chest and abdomen during an asthma attack, for example,
are believed to aggravate GERD. As the lungs swell, the increased pressure on
the stomach may cause the muscles that usually prevent acid reflux to become
lax. This allows stomach acid to flow back up into the esophagus.

Symptoms

Heartburn is the main GERD symptom that
adults face. In some people, however, GERD can occur without causing heartburn.
Instead, symptoms may be more asthmatic in nature, such as a chronic dry cough
or difficulty swallowing.

Your asthma may be connected to GERD if:

asthma symptoms begin in
adulthood

asthma symptoms get worse
following a large meal or exercise

asthma symptoms occur while
drinking alcoholic beverages

asthma symptoms happen at night
or while lying down

asthma medications are less effective
than usual

It can be difficult to identify symptoms of
GERD in children, especially if they’re very young. Infants under age 1 will
often experience symptoms of acid reflux, such as frequent spitting up or
vomiting, with no harmful effects.

In general, infants and young children with
GERD will:

become irritable

arch their backs often (usually
during or immediately following feedings)

refuse to eat

experience poor growth (both in
terms of height and weight)

In older toddlers and children, GERD may cause:

nausea

heartburn

repeated regurgitation

symptoms of asthma, such as
coughing, shortness of breath, and wheezing

Medical Treatments

Until recently, it was believed that
controlling "silent" acid reflux with proton pump inhibitors (PPIs),
such as esomeprazole (Nexium) and omeprazole (Prilosec), would help relieve
asthmatic symptoms as well. However, a 2009 study published in the New England Journal of Medicinequestioned
the drugs' effectiveness in treating severe asthma attacks. During the nearly
six-month-long study, there was no difference in the rate of severe attacks
between people taking medication and those taking a placebo.

Before the study, researchers estimated that
between 15 and 65 percent of people with asthma took PPIs to manage GERD
symptoms and control severe asthma attacks. Due to the suspected
ineffectiveness of these drugs, however, those with asthma may want to consider
other medications to treat their condition.

Make sure you talk to your doctor before
changing or abandoning your asthma medications. Some medicines that are
commonly used to treat asthma, such as theophylline and beta-adrenergic
bronchodilators, may aggravate acid reflux.

Lifestyle and Home Remedies

Since certain medications can be ineffective in
treating GERD and asthma simultaneously, the best treatment for these
conditions may consist of lifestyle and home remedies.

Controlling
GERD Symptoms

To help control or prevent GERD symptoms, you
can try:

losing excess weight

quitting smoking

avoiding foods or drinks that
contribute to acid reflux, such as:

alcoholic or caffeinated
beverages

chocolate

citrus fruits

fried foods

spicy foods

high-fat foods

garlic

onions

mints

tomato-based foods, such as
pizza, salsa, and spaghetti sauce

eating smaller meals more often
instead of eating larger meals three times a day

eating meals at least three to
four hours before bedtime

using a wedge pillow or raising
the head of the bed 6 to 8 inches by placing blocks underneath bedposts

wearing loose clothing and belts

When these strategies and treatments don’t
work, surgery is usually an effective last resort in treating GERD.

Controlling
Acid Reflux in Children

A few easy strategies for avoiding acid
reflux in children include:

burping infants several times
during feeding

keeping infants in an upright
position for 30 minutes after feeding

feeding children smaller, more frequent
meals

not feeding children foods that
can trigger acid reflux (noted above)

Controlling
Asthma Symptoms

To relieve asthma symptoms, you may want to
consider trying:

ginkgo extract

natural herbs, such as butterbur
and dried ivy

fish oil supplements

yoga

deep breathing exercises

Make sure to consult with your doctor before
you try any herbs, supplements, or alternative treatments. Your doctor may be
able to recommend an effective treatment plan that can help prevent your asthma
and GERD symptoms.